Childbirth Preparation Research Articles

The effect of in-person and virtual prenatal care education of the spouses of primiparous women on the father and mother\u2019s attachment to infant: a quasi-experimental and controlled study

IntroductionConsidering the important role of education in promoting parents’ attachment to the infant, temporal and spatial limitations, and the need to use new educational methods for spouses’ participation in childbirth preparation classes, the present study was conducted to compare the effect of in-person and virtual prenatal care education of the spouses of primiparous women on the father and mother’s attachment to the infant.MethodsThis is a quasi-experimental clinical trial that was conducted on primiparous pregnant women referring to three prenatal clinics in Tehran, Iran. Sampling was done by continuous method and pregnant women were divided into three groups of face-to-face education (n = 28), virtual education (n = 31), and control (n = 29). The content of the training program in the virtual and face-to-face groups was similar, which was presented in 4 sessions. At 18–20 weeks of gestation, demographic characteristics and pregnancy records were obtained from the samples, and 12 weeks after the delivery, maternal postnatal attachment scale, and postnatal paternal-infant attachment questionnaire were completed. Both intention-to-treat analysis and per-protocol analysis were performed.ResultsThere was a statistically significant difference between the two groups of in-person education and control, and also virtual education and control for both intention-to-treat and per-protocol analysis (p < 0.05). However, no statistically significant difference was found between the two groups of in-person and virtual education. Results showed a large and medium effect size between the two groups of in-person education and control, and virtual education and control in terms of father-infant attachment score, respectively. There was also no statistically significant difference between the three groups after the educational intervention in terms of the mother-infant attachment score for both intention-to-treat and per-protocol analysis.ConclusionConsidering that education by both in-person and virtual methods had the same effect on improving the score of father-infant attachment, it is suggested that to increase the participation of spouses of pregnant women in the process of prenatal care, the spouses of pregnant women should have the option of virtual education in addition to in-person training.Trial registrationTCTR.ir TCTR20200515011. Registered on May 12, 2020.

Effectiveness of Mindfulness on Labour Pain Among Nulliparous Women

The management of labour pain, despite much research in its regard, remains a complex and difficult subject. Mindfulness-based cognitive therapy is addressed as a relatively new method of managing acute pain; however, it is less often used in midwifery. Therefore, the present study was carried out to evaluate the effectiveness of mindfulness-based interventions on labour pain. METHODS: This is a clinical trial study in which 158 women, who referred to childbirth preparation classes, were allocated to two groups using simple randomisation. The intervention group was trained in mindfulness techniques during eight sessions by a trained midwife. Women in the control group received routine pregnancy care. On the day of delivery, the pain intensity and the immediate pregnancy outcomes in both groups were assessed. Data were collected using the Visual Analogue Scale and the delivery checklist. Collected data were then analysed using SPSS (a software package used for statistical analysis) and a Mann-Whitney U test. RESULTS: During admission to the labour ward, the pain intensity among participants in both groups was moderate, and there was no significant difference (0.10). At the beginning of the active phase (4 – 6 cm of dilation), and 7 – 8 cm of dilatation and 9 – 10 cm of dilatation, the pain intensity was significantly lower in women in the intervention group (p=0.001). No difference regarding the maternal and fetal complications in pregnancy was observed between participants in the intervention and control groups. In addition, the need to apply other pain relief methods in participants in the intervention group was significantly less than participants in the control group (p=0.001). CONCLUSIONS: According to the findings of this study, it can be concluded that mindfulness is a successful and uncomplicated method to reduce labour pain. These findings could be used by midwives to provide holistic care to pregnant women.

Current aspects of the progress of labor in healthy women according to the data of the retrospective analysis

Purpose of the work – to study the current aspects of the course of labor in healthy women using retrospective indicators.Material and methods. To study this topic, an analysis of 1.078 births of women who were born on the basis of the maternity ward for pregnant women with obstetric pathology of the State Institution «Institute of Pediatrics,Obstetrics and Gynecology named after acad. O.M. Lukyanova National Academy of Medical Sciences of Ukraine». It was found that of all births, the proportion of first-borns was 602 (55.8 %) women, of whom 451 (41.8 %) were pregnant, and only 86 (8 %) were healthy pregnant women, which we will study in the future.Results. It was found that among 86 births, the frequency of physiological births was 64 %, of which in 47.7 % of cases childbirth was complicated, and pathological – 36 %. The most common complications during childbirth were: premature rupture of membranes (PRPO), episio- and perineotomy, trauma to the birth canal. The causes of pathological childbirth in the examined women were: abnormalities of labor, fetal distress, defect of manure and membranes, clinically narrow pelvis, malposition of the fetus and early postpartum hemorrhage. All children were born alive. It should be noted that all births, where the Apgar score was ≤ 6 points, had no partner support, and the women themselves did not undergo any preparation for childbirth. Conclusions. According to our data, in almost healthy women who gave birth for the first time and had no perinatal loss in the anamnesis, did not undergo prenatal training and did not have partner support during childbirth, the number of complications during childbirth is increasing. Therefore, this group of healthy pregnant women needs more detailed study and analysis, development of prenatal training algorithms to improve perinatal indicators.

Physiotherapy in preparation for childbirth does not consider osteoraticular preparation

Background: The dilation period of labor requires mobility of the sacroiliac joints, which may not be fully mobile or adapted in all women. Physical therapy, on the other hand, has tools to release these joints. Aims: To verify whether the literature contemplates both the preparation service for the osteoarticular portion of the birth canal and for the soft tissues. Methods: A review was carried out, without language restrictions, in the LILACS, PEDro, Pubmed and SciELO databases. Results: A total of 49 articles were selected according to whether they contain physical therapy techniques in preparation for childbirth or not. Most studies addressed physical therapy for pelvic floor muscles and treatments for low back pain and urinary incontinence. There have been no studies dealing with the preparation of the bone part for childbirth. Conclusion: Pelvic physiotherapy in preparation for childbirth minimizes the occurrence of pelvic floor disorders, but the techniques are restricted to the treatment of lumbar symptoms and soft tissue preparation only, without taking into account the preparation of the bony birth canal, which it is nonsense since there is physical therapy to improve the mobility of the sacroiliac joints, which are fundamental in optimizing the evolution of the entire delivery treatment.

Importance of pelvic floor muscle trainig in preparing for vaginal birth

Background: Pregnancy, type of delivery, pelvic floor conditions and number of births can influence the muscle strength of the pelvic floor, causing morbidities of the genitourinary tract and negative effects related to sexual, physical, psychological and social health in women. However, few studies deal with the training of the pelvic floor muscles (PFM) during pregnancy, or in preparation for vaginal delivery. Aims: to discuss the importance of pelvic floor muscle training in childbirth preparation. Method: systematic review in SCIELO, MEDLINE, BIREME, Cochrane, Expanded Academic Index, Clinical Evidence and Pubmed databases using the keywords pregnancy and pelvic floor exercise, restricted to studies in Portuguese or English about pregnant women. Results: Of the 44 articles included, only eight dealt directly with PFM strengthening during pregnancy. Conclusion: Pelvic floor muscle exercises during pregnancy are safe and have no side effects or potential risks for pregnant women, in addition to promoting effective strengthening and increased tissue elasticity, variables capable of facilitating vaginal delivery and minimizing the risk of injuries locations and consequent impairments of pelvic, urinary, anorectal and/or sexual or pelvic statics.

ASSESSMENT OF THE LABOR COURSE AND POSTNATAL PERIOD DEPENDING ON THE TYPES OF CONDUCTING ANTINATAL PREPARATION

The aim – to conduct a comparative assessment of the condition of newborns, dependingon different types of antenatal preparation.Material and methods. The study was carried out on the basis of the maternitydepartment for pregnants and parturient women with obstetric pathology of the StateInstitution “Institute of Pediatrics of Obstetrics and Gynecology named after V.I. acad.EAT. Lukyanova National Academy of Medical Sciences of Ukraine ". The first groupincluded 45 pregnant women who underwent a course of psychophysical training withpositive motivation for partner childbirth. The second group consisted of 45 pregnantwomen, also underwent a course of psychophysical training with positive motivation forpartner labor, but had a desire not to carry out pain relief during childbirth, therefore,they chose training using the method of transcranial electrical stimulation (TES) of brainstructures. All pregnant women underwent a determination of their psychoemotional stateto define the level of situational anxiety according to the method of Ch.D. Spielberger andYu.L. Khanin. The second group of pregnant women was tested after the fourth EFTprocedure and again the day before delivery. The threshold of pain sensitivity of apregnant woman in each group was also determined. Subjective assessment was carriedout for women in labor on the first day after delivery and using a verbal descriptivescale for assessing pain (Verbal Descriptor Scale, 1990). To assess the condition of thefetus during childbirth, cardiotocographic studies were carried out, and after birth – anassessment on the Apgar scale at the first and fifth minutes.Results. In women who underwent a course of psychophysical training with positivemotivation for partner childbirth together with the method of transcranial electricalstimulation, physiological childbirth proceeded 1.2 times more often than in womenpatients who did not undergo prenatal training (88.9 % versus 75.6 %, respectively).Allchildbirth, occurred in the second group, began on their own and did not require laborinduction, but in the first group this indicator was 6.3% of cases.Conclusions. It has been established that prenatal preparation has a positive effect notonly on the condition of the woman, but also on the condition of the fetus and newborn.Psychophysical preparation for childbirth with motivation for partner support using theTES method significantly increases the pain tolerance threshold, improves the courseof childbirth and the possibility of adaptive mechanisms of the mother and fetus, asevidenced by the assessment of points on the Apgar scale, adaptation of newborns, earlyattachment to the breast, joint stay of mother and child.

INOVASI LAYANAN PERSIAPAN PERSALINAN (EDUKASI DAN SENAM HAMIL) PADA IBU HAMIL DI WILAYAH KERJA UPT PUSKESMAS ALAS BARAT KABUPATEN SUMBAWA

The labor process is influenced by three factors, namely Passage (birth canal), Passanger (fetus), Power (strength). Childbirth can run normally if all three factors are met properly. In addition, there are other factors that affect the delivery process, namely psychological and helper. Maternal Mortality Rate (MMR) can be reduced by various efforts, both promotive and preventive, by providing education in preparation for childbirth. This education can be an alternative for pregnant women to find out the extent of maternal and fetal development, increase maternal independence and train coping management for maternal stressors. Pregnancy exercise is a form of coping method that can avoid the occurrence of physical stress due to pregnancy, such as reducing leg and back cramps, increasing the mother's ability to adapt to changes in her body. This study aims to identify the effect of labor preparation services (pregnancy education and exercise) on the preparation for delivery of pregnant women in the working area of ??the UPT Puskesmas Alas Barat. Pre-experimental research design with one group pretest-post test design. The instrument used for data collection is a questionnaire. Testing the instrument using the product moment person validity test and reliability test. The analysis used is simple linear regression with the number of respondents as many as 102 pregnant women. The results showed that the regression significance value of the delivery preparation service variable (pregnancy education and exercise) on the preparation for delivery of pregnant women was 0.000 or less than 0.05. The hypothesis which states that delivery preparation services (pregnancy education and exercise) has an effect on preparation for delivery of pregnant women (accepted). Based on the results of this study, it can be suggested that pregnant women play an active role in participating in activities during pregnancy so that mothers have knowledge about the needs during pregnancy, especially preparation for childbirth so as to minimize emergencies to the mother and fetus during the delivery process.

Comparison of the Effect of Teaching an Educational Package to Spouses Using Two Methods of In-Person and Distance Education in Childbirth Preparation Classes on Pregnant Women's Mental Health

Background & aim: Spouses’ participation in childbirth preparation classes seems to be effective in the promotion of pregnant women's mental health. Considering the barriers to spouses' participation in these classes, this study aimed to determine the effect of teaching an educational package to spouses using two methods of in-person and distance education in childbirth preparation classes on pregnant women's mental health.Methods: This quasi-experimental study was conducted on 102 pregnant women and their husbands in health centers of Mashhad, Iran, in 2019. The subjects were randomly assigned to three groups of in-person education (n=35), distance education (n=33), and control (n=34).In the in-person education group, spouses attended in the third and eighth sessions. In the distance education group, an educational package was delivered to spouses, followed by follow-up calls within three weeks to resolve possible ambiguities. In the control group, the spouses did not receive any training. Pregnant women's mental health was assessed by the General Health Questionnaire-28 before, immediately after, and three weeks after the intervention.Results: The mean scores of mental health in the three groups did not differ before the intervention (p <0.05).In the distance education group, the mean scores of mental health decreased by 16.1 and 20.1 after the intervention and in the follow-up stage, compared to the control group (p <0.001). In the in-person education group, there were no significant changes in the scores in any stages of pre-intervention, post-intervention, and follow-up, compared to the control group (p <0.05).Conclusion: Distance education of spouses in childbirth preparation classes was more effective in the promotion of pregnant women's mental health, compared to in-person education.

Coping With the Unexpected in Childbirth: A Thematic Analysis.

This article reports original research that describes new mothers' experiences of birth and maternity care. Qualitative data were collected through a survey on birth satisfaction, which included space for women to provide comments about their birth and experience of care. Thirty-nine women provided comments that were analyzed using the thematic analysis method. Two themes emerged from the women's experiences: "Unexpected birth processes: expectations and reality" and "Coping with birth: the role of health-care staff." Participants described unexpected birthing processes, their experiences of care, and maternity care staff's contributions to coping with birth. Implications for practice for childbirth professionals include promotion of physiologic birth, respectful person-centered care during all phases of perinatal care, and the value of childbirth preparation.

Evaluating the Effectiveness of Childbirth Preparation Courses on Women's Self-Efficacy among Ultra-Orthodox Jewish Religious Women in Israel.

Background: This study examined the effectiveness of a birth preparation course on coping with childbirth among primigravid ultra-orthodox Jewish women in Israel. Methods: In total, 130 ultra-orthodox 25–35-week primigravid women were divided into a study (n = 100, participated in birth preparation courses) and a control (n = 30, did not participate in the courses) group. A questionnaire was delivered three times: T1—before the course/delivery, T2—two–three days after delivery, and T3—a month after delivery. Results: At T3, self-efficacy among the study group was higher than in the control group. Differences in self-efficacy were found over time regardless of the group (F(2,246) = 12.83, p < 0.001), as a time–group interaction effect (F(2,246) = 10.20, p < 0.01). Self-efficacy in the study group (Mean, M = 3.40, Standard deviation, SD = 0.63 at T1) dropped to M = 3.06, SD = 0.76 at T2 and rose to M = 3.34, SD = 0.64 at T3. In the control group, self-efficacy (M = 3.53, SD = 0.56 at T1) dropped to M = 3.26, SD = 0.63 at T2 and to M = 2.95, SD = 0.76 at T3. Discussion: The childbirth preparation course was found to be effective in raising self-efficacy among primigravid ultra-orthodox religious women when compared to the control group.

Диференційна діагностика тромбоцитопенії під час вагітності: клінічні і діагностичні алгоритми

Purpose — to create an algorithm for early diagnosis and differential diagnosis of conditions accompanied by thrombocytopenia (TP) during pregnancy, as well as an algorithm for the treatment of immune thrombocytopenia during pregnancy based on analysis of clinical, laboratory data and obstetric and perinatal results of such pregnant women. Materials and methods. We analyzed 155 histories of pregnancy and childbirth of women with TP, who underwent inpatient treatment and/or gave childbirth in the obstetric clinic of the State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova NAMS of Ukraine» from January 2008 to August 2018. According to the inclusion criteria, 111 histories were selected for further analysis. Pregnant women are divided according to the etiological principle of TP into three groups: with gestational thrombocytopenia, immune thrombocytopenia, secondary thrombocytopenia. The first group included 32 women (28.8%), the second — 65 (55.6%), the third — 14 (12.6%). During the selected period of time there were 99 births, 100 babies were born, 1 twin birth. Results and conclusions. The number of platelets progressively decreases during pregnancy with a minimum in childbirth. The algorithm of examination, the decision on the initiation or intensification of treatment, the choice of monitoring tactics for TP during pregnancy, the calculation of obstetric and perinatal risks, preparation for childbirth and the choice of method depend on the cause of TP and differ significantly. Developed «Algorithm for diagnosis and differential diagnosis in the detection of thrombocytopenia during pregnancy» and «Algorithm for the treatment of immune thrombocytopenia during pregnancy» are aimed at the prevention of obstetric and perinatal complications in pregnant women with thrombocytopenia. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: thrombocytopenia, pregnancy, diagnostic algorithm, treatment algorithm.

Fear of childbirth in Iran: A systematic review of psychological intervention research.

BackgroundDue to the fear of childbirth (FOC) and failure to provide painless delivery in Iran, the prevalence rate of elective cesarean section (C-section) performed on request by pregnant women is on the rise. However, no systematic review assessing the results of studies in this respect has been thus far developed.ObjectiveTo systematically review published psychological intervention research reflecting on FOC in Iran.Materials and MethodsIn this systematic review, the databases of PubMed, MEDLINE, PsycINFO, Wiley, ISI Web of Science, Scopus, Science Direct, Cochrane Library, Google Scholar, and Scientific Information Database were searched to retrieve the relevant studies. Manual searches were performed to find the relevant articles and finally 21 intervention studies were reviewed.ResultsBased on the modified Jadad Scale, a methodological quality (risk of bias) assessment tool, 14 and 7 studies had acceptable or good and low quality, respectively. The included articles covered fear, fear of childbirth, pregnancy, and psychological intervention in Iran. Cognitive behavioral therapy, relaxation techniques, psychological counseling, childbirth preparation classes (CPCs), mindfulness programs, and psychoeducation had been also practiced as the main types of psychological interventions for reducing FOC in pregnant women.ConclusionThere was no clear evidence to establish the most effective method for minimizing levels of FOC in pregnant women. Based on the assessment tool and since most of the studies had moderate or low quality, conducting standard and high-quality randomized controlled trials focusing on FOC in pregnant women is of most importance in Iranian population.

Challenges in using Mental Contrasting with Implementation Intentions (MCII) for preparation for natural birth: A feasibility study

ObjectiveWomen who plan a natural birth can benefit from strategies and/or resources that help them prepare for and cope with labour pain. This study aims to identify the feasibility of using Mental Contrasting with Implementation Intentions (MCII) for preparation of primiparous women for natural childbirth. Secondary aims are to test the acceptability of a health-focused information leaflet, and to describe how participants with high natural birth intentions cognitively prepare for birth. MethodsIn third trimester, ten primiparous women participated in this interventional study with follow-up. A health-focused information leaflet on physiological childbirth, MCII, a mental strategy that helps people achieve a desired goal by envisioning obstacles and how to overcome them, and a researcher-developed questionnaire which contained the CBSEI-C32, was used. Survey data were analysed using a combination of descriptive statistics and deductive theoretical thematic analysis. ResultsThe health-focused leaflet was exclusively judged positively. Nine women did not use MCII as instructed, they did not find it helpful for childbirth preparation and wished to have a more positive, health-focused approach towards childbirth. Two themes emerged from the participants’ responses: 'the ability to give birth' which was supported through childbirth preparedness, coping strategies, confidence and external supports and 'the uncertainty of giving birth' which included fears and worries about possible adverse events and the baby’s health. ConclusionMCII was not a promising tool for natural childbirth preparation among primiparous women in Germany. Our findings show that women prefer a positive, health-focused approach, rather than thinking about overcoming obstacles, when they prepare for childbirth.

The effect of yoga on the delivery and neonatal outcomes in nulliparous pregnant women in Iran: a clinical trial study

BackgroundYoga can reduce the risk of preterm delivery, cesarean section (CS), and fetal death. The aim of the present study was to investigate the effects of Yoga on pregnancy, delivery, and neonatal outcomes.MethodsThis was a clinical trial study and using the random sampling without replacement 70 pregnant women entered Hatha Yoga and control groups according to the color of the ball they took from a bag containing two balls (blue or red). The data collection tool was a questionnaire pregnancy, delivery, and neonatal outcomes. The intervention in this study included pregnancy Hatha Yoga exercises that first session of pregnancy Yoga started from the 26th week and samples attended the last session in the 37th week. They exercised Yoga twice a week (each session lasting 75 min) in a Yoga specialized sports club. The control group received the routine prenatal care that all pregnant women receive.ResultsThe results showed that yoga reduced the induction of labor, the episiotomy rupture, duration of labor, also had a significant effect on normal birth weight and delivery at the appropriate gestational age. There were significant differences between the first and second Apgar scores of the infants.ConclusionThe results of the present study showed that Yoga can improve the outcomes of pregnancy and childbirth. They can be used as part of the care protocol along with childbirth preparation classes to reduce the complications of pregnancy and childbirth.Trial registrationIRCT20180623040197N2 (2019-02-11).

Percepção de enfermeiros da rede cegonha sobre sinais do início do trabalho de parto

Objetivos: Identificar os sinais de início de trabalho de parto, segundo os profissionais da rede cegonha. Metodologia: Trata-se de um estudo transversal, com abordagem de dados primários, realizado em unidades da Rede Cegonha, no período de agosto de 2017 a julho de 2019. A amostragem foi de 84 enfermeiros. A coleta de dados foi efetuada por formulário contendo variáveis de interesse do estudo. Efetuou-se estatística descritiva, para toda a estatística adotou-se o nível de significância de 5%. Esta pesquisa foi aprovada sob-registro CAAE: 87854418.3.0000.5187.Resultados: Quanto aos sinais de início do trabalho de parto foram citados: saída do tampão mucoso, contrações que aumentam sua força constantemente e dor que inicia na região lombar e migra para o púbis (47,94%, n=35).Também foram citadas: contrações uterinas com padrão diferente das recomendações vigentes e perdas vaginais (52,63%, n=40); contrações, perdas vaginais e dilatação (10,52%, n=8); só contrações (15,76%, n=12). Conclusões: Não há apenas um sinal ou sintoma que seja definitivo para identificação do início de trabalho de parto, mas que deve-se levar em consideração a subjetividade e multifatoriedade que envolve o atendimento, reconhecendo cada sinal e sintoma. Sendo necessário o aperfeiçoamento do preparo para o parto a fim de colaborar para uma melhor assistência.

Alcohol and illicit and non-medical prescription drug use before and during pregnancy in Stockholm, Sweden: A cross-sectional study

ObjectivesTo provide current estimates of alcohol and drug use among pregnant women attending antenatal care lectures in preparation for childbirth in Stockholm, Sweden. Study designA cross-sectional study. Data was collected anonymously among women attending lectures in preparation for childbirth. Main outcome measuresThe prevalence of alcohol and illicit and non-medical prescription drug use among pregnant women attending antenatal care lectures in preparation for childbirth. ResultsNine hundred and thirty-six pregnant women attending lectures in preparation for childbirth participated. Among those answering all questions about alcohol use during pregnancy, 4.2 percent reported use (95% confidence interval (CI), 3.0–5.7%) and among those answering all questions about illicit or non-medical prescription drug use during pregnancy, 0.5 percent reported such use (95% CI, 0.1–1.3%). The prevalences of binge drinking during pregnancy and alcohol and drug use before pregnancy are presented. Comparisons of anonymously and non-anonymously collected data are included. ConclusionsApproximately one in 25 women reported using alcohol and approximately one in 200 reported using illicit or non-medical prescription drugs while pregnant. Alcohol use during pregnancy may have decreased in Stockholm, Sweden.

Traversing Traditions: Prenatal Care and Birthing Practice Preferences Among Black Women in North Florida.

Our goal was to explore prenatal practices and birthing experiences among Black women living in an urban North Florida community. Non-random qualitative study. Private spaces at a convenient location selected by the participant. Eleven Black women, aged 25-36 years, who were either pregnant or had given birth at least once in the past five years in North Florida. Semi-structured interviews were completed in July 2017, followed by thematic analysis of interview transcripts. Four main themes emerged: a) decision-making strategies for employing alternative childbirth preparation (ie, midwives, birthing centers, and doulas); b) having access to formal community resources to support their desired approaches to perinatal care; c) seeking advice from women with similar perspectives on birthing and parenting; and d) being confident in one's decisions. Despite seeking to incorporate "alternative" methods into their birthing plans, the majority of our participants ultimately delivered in-hospital. Preliminary results suggest that culturally relevant and patient-centered decision-making might enhance Black women's perinatal experience although further research is needed to see if these findings are generalizable to a heterogenous US Black population. Implications for childbirth educators and health care professionals include: 1) recognizing the importance of racially and professionally diverse staffing in obstetric care practices; 2) empowering patients to communicate and achieve their childbirth desires; 3) ensuring an environment that is not only free of discrimination and disrespect, but that embodies respect (as perceived by patients of varied racial backgrounds) and cultural competence; and, 4) providing access to education and care outside of traditional work hours.

Implementation of Virtual and Face-to-Face Childbirth Preparation Training for the Spouses of the Primiparous Women to Reduce the Fear of Childbirth, Improve the Pregnancy Experience, and Enhance Mother- and Father-Infant Attachment: Protocol for a Quasiexperimental Clinical Trial.

Background Men have a special role to play in promoting maternal and child health during pregnancy, childbirth, and postpartum period. The health of women also requires the participation and cooperation of men. The aim of this study is to compare the effect of virtual and face-to-face childbirth preparation training for spouses of the primiparous women on the pregnancy experience, fear of childbirth (FOC), and mother- and father-infant attachment. Methods The primiparous women attending the prenatal clinics of Lolagar Hospital and Azadi and Tehransar health centers of Tehran along with their husbands will be studied. The inclusion criteria for the women's husbands are the first experience of becoming a father, being at least 18 years of age, and the ability to read and write. The exclusion criteria for women's husbands are the history of physical/mental illness; being a smoker; and consuming alcohol, drugs, or psychotropic substances. The participants will be selected by the convenience sampling method and will be divided into three groups of study A, study B, and control. Spouses in study groups A and B will receive childbirth training through virtual and face-to-face methods with similar content, respectively. The control group only receives ordinary prenatal care. At the 18–20 weeks of gestation, demographic information, pregnancy experience scale (PES), and version A of Wijma delivery expectancy/experience questionnaire (WDEQ-A) will be completed. At 37-38 weeks of gestation, the PES and WDEQ-A questionnaires will be completed again and maternal postnatal attachment scale (MPAS) and postnatal paternal-infant attachment questionnaire (PPAQ) will be completed by the parents 12 weeks after the delivery. Discussion. Improving the experience of pregnancy, especially reducing the FOC and creating a positive attitude towards it, is a vital strategy to promote vaginal childbirth and reduce the number of cesarean sections requested by women. Achieving this will reduce the cost of health care and improve the quality of life during pregnancy, after childbirth, and during the growth and development of infants. Ethics and Dissemination. This research has been funded by the Iran University of Medical Sciences, approved by the Thailand Registry of Clinical Trials, and will commence in May 2020. Results will be disseminated through peer-reviewed journals and shared with the academic and medical community to pregnancy and childbirth outcomes. This trial is registered with TCTR20200515011.

Birth Preparation and Complication Readiness among Antenatal Care Attendants in Bule Hora Governmental Health Facilities in Oromia Region, Ethiopia, in 2019

Background & aim: Childbirth preparation has been globally supported as an important part of safe maternity program. Birth preparedness and complication readiness (BP and CR) aimed to reduce delays in seeking care, arrival, and care during childbirth and immediate postpartum period. The aim of this study was to assess the knowledge and practice of BP and CR, as well as its associated factors, among antenatal care attendants in Bule Hora town in the Oromia region in Ethiopia. Methods: This facility-based cross-sectional study was conducted within February to June 2019. A total of 272 women were selected using systematic sampling and interviewed by previously tested structured questionnaires. Data analyzed using Epi Info (version 6.4) and SPSS software (version 25) with binary logistic regression and multiple logistic regression analyses. Results: Out of 272 mothers, 46.3% practiced four or more BP and CR steps. Attendance in secondary school (OR=2.42; 95% CI: 1.73-5.48) and college or university (OR=4.12; 95% CI: 1.61-7.87), maternal occupation (OR=4.12; 95% CI: 2.64-9.69), having 1-3 (OR=1.49; 95% CI: 1.08-6.96) and higher than or equal to 4 prenatal visits (OR=3.54; 95% CI: 1.72-9.03), knowledge of main warning signs during pregnancy (OR=6.68, 95% CI: 4.80-11.77) and also during labor and childbirth (OR=4.54; 95% CI: 2.20-10.28), were independent predictors associated with BP and CR practice. Conclusion: The level of BP and CR among women in the study area was low. In general, policymakers and planners should improve BP and CR in women and provide pregnant women, their families, and communities with associated information.

Childbirth expectations questionnaire – a psychometric study with a sample from brazil

IntroductionThe Childbirth Expectations Questionnaire (CEQ; Gupton, A., Beaton, J., Sloan, J. &amp; Bramadat, I.; 1991) evaluates the women childbirth expectation’s with 34 items organized in four dimensions: Pain and coping; Significant others; Nursing support and Interventions.ObjectivesTo analyze the psychometric properties (construct validity using Confirmatory Factor Analysis, discriminant validity and reliability) of the Brazilian preliminary version of CEQ.Methods350 women (Mean age: 30.01±5.452) in the second trimester of pregnancy (Mean weeks of gestation=25.17±6.55), with uncomplicated pregnancies, completed the CEQ. To analyze discriminant validity, thirty of these women participated in a workshop (12 hours, integrated in the GentleBirth, a specific perinatal education intervention program) and fill in the CEQ again after approximately 8 weeks.ResultsAfter deleting seven items (1-3-20-24-33-34-35) and some errors were correlated the four-dimensional second-order model of CEQ presented good fit (χ2=2.496; RMSEA=.071; CFI=.845, TLI=.828). The CEQ Cronbach’s alpha for the total was α=.90; all factors presented good reliability: Pain coping (α=.87); Significant others (α=.66), Nursing support (α=.84), and Interventions (α=.76). The CEQ mean scores (total, Pain coping and Nursing support) were significantly higher after the workshop, indicating more positive expectations for childbirth (p&lt;.05).ConclusionsThis additional validation study emphasizes that CEQ is an adequate measure of expectations of labour. It will be very useful to understand the correlates of childbirth expectations and also to access the efficacy of childbirth preparation programs.